| Doctor Name: | DR. WANDA JEANNE MICHAELS |
| NPI Number: | 1811924459 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | J4922 |
| Business Practice Address: | 13646 Fm 849 Lindale, TX - 757715052 |
| Business Phone Number: | 8006891527 |
| Business Fax Number: | 8006891527 |
| Mailing Address: | Po Box 519, LINDALE |
| State: | TX |
| Postal Code: | 757710519 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2006 |
| NPI Last Update Date: | 06/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | J4922 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |